ObamaCare rates trigger more sticker shock | Fox News.
Unfortunately this story is short on details….
Before the exchanges opened, his insurance company said his rates would soar. But now that there are subsidies, he’s been trying for days to find out how much he would get.
“To logically compare plans, I’ve been calling them every day since October 1st,” says Mangione, “several times a day on some occasions. Sometimes enduring 45, 50 minute holds, half an hour holds.”
Although Kentucky officials were unable to give him a firm number on his subsidy because of repeated IT problems, they did refer him to a Kaiser Family Foundation site, which suggests his subsidy will be $414 a month — on a premium of $868.
So we have a guess, most likely not accurate, regarding the subsidy that Andy and his family is eligible for. We don’t know if the $868 premium is for a Bronze, Silver, Gold or Platinum plan and we do know the family size if 4 (see below). We also don’t know what his present insurance costs, so how do we know he is experiencing “sticker shock”?
Moving forward, Andy has received some details on plans that are “similar” to what he apparently has, but one of his concerns is the ER visit copay…
And his co-pay for emergency room visits almost tripled — from $125 to $350 — an important factor for a family with two young boys.
“They’re climbing trees, they’re falling out of trees. They’re running around falling off their bike, they’re very active. They’re not unlike any other 8 and 10 year old boys,” their dad says.
That is an issue that’s easily addressed with a supplemental accident plan.
The bottom line is after reading this article, the only factual information presented is that Andy has a family size of 4 and he has a non-subsidized quote of $858 for some unknown metallic plan. I’m guessing it’s a Bronze plan based on the high ER copay.
Another very real issue is that he found a less expensive plan but his doctor is out of network. Expect to see that refrain repeated over and over.
Getting back to the subsidy, someone needs to explain to Andy that what really happens with the subsidy is the premium that he has to pay is capped as a percentage of his income based on the Federal Poverty Level. For example, if Andy makes $47,100 per year, the most he would pay for the 2nd lowest cost silver plan is 6.3% of his income, which would translate to $247/mo. His subsidy amount is determined as the difference between the $247 and the list price of the 2nd lowest cost Silver plan. That subsidy would be used to subtract from the list price of ANY plan he chose.
It sure seems like a knowledgeable navigator at the Kentucky exchange could use the above informatino to provide Andy with a very good ballpakr estimate of what his subsidy would be.